今早為Asian Medical Students Association Hong Kong (AMSAHK)的新一屆執行委員會就職典禮作致詞分享嘉賓,題目為「疫情中的健康不公平」。
感謝他們的熱情款待以及為整段致詞拍了影片。以下我附上致詞的英文原稿:
It's been my honor to be invited to give the closing remarks for the Inauguration Ceremony for the incoming executive committee of the Asian Medical Students' Association Hong Kong (AMSAHK) this morning. A video has been taken for the remarks I made regarding health inequalities during the COVID-19 pandemic (big thanks to the student who withstood the soreness of her arm for holding the camera up for 15 minutes straight), and here's the transcript of the main body of the speech that goes with this video:
//The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, continues to be rampant around the world since early 2020, resulting in more than 55 million cases and 1.3 million deaths worldwide as of today. (So no! It’s not a hoax for those conspiracy theorists out there!) A higher rate of incidence and deaths, as well as worse health-related quality of life have been widely observed in the socially disadvantaged groups, including people of lower socioeconomic position, older persons, migrants, ethnic minority and communities of color, etc. While epidemiologists and scientists around the world are dedicated in gathering scientific evidence on the specific causes and determinants of the health inequalities observed in different countries and regions, we can apply the Social Determinants of Health Conceptual Framework developed by the World Health Organization team led by the eminent Prof Sir Michael Marmot, world’s leading social epidemiologist, to understand and delineate these social determinants of health inequalities related to the COVID-19 pandemic.
According to this framework, social determinants of health can be largely categorized into two types – 1) the lower stream, intermediary determinants, and 2) the upper stream, structural and macro-environmental determinants. For the COVID-19 pandemic, we realized that the lower stream factors may include material circumstances, such as people’s living and working conditions. For instance, the nature of the occupations of these people of lower socioeconomic position tends to require them to travel outside to work, i.e., they cannot work from home, which is a luxury for people who can afford to do it. This lack of choice in the location of occupation may expose them to greater risk of infection through more transportation and interactions with strangers. We have also seen infection clusters among crowded places like elderly homes, public housing estates, and boarding houses for foreign domestic helpers. Moreover, these socially disadvantaged people tend to have lower financial and social capital – it can be observed that they were more likely to be deprived of personal protective equipment like face masks and hand sanitizers, especially during the earlier days of the pandemic. On the other hand, the upper stream, structural determinants of health may include policies related to public health, education, macroeconomics, social protection and welfare, as well as our governance… and last, but not least, our culture and values. If the socioeconomic and political contexts are not favorable to the socially disadvantaged, their health and well-being will be disproportionately affected by the pandemic. Therefore, if we, as a society, espouse to address and reduce the problem of health inequalities, social determinants of health cannot be overlooked in devising and designing any public health-related strategies, measures and policies.
Although a higher rate of incidence and deaths have been widely observed in the socially disadvantaged groups, especially in countries with severe COVID-19 outbreaks, this phenomenon seems to be less discussed and less covered by media in Hong Kong, where the disease incidence is relatively low when compared with other countries around the world. Before the resurgence of local cases in early July, local spread of COVID-19 was sporadic and most cases were imported. In the earlier days of the pandemic, most cases were primarily imported by travelers and return-students studying overseas, leading to a minor surge between mid-March and mid-April of 874 new cases. Most of these cases during Spring were people who could afford to travel and study abroad, and thus tended to be more well-off. Therefore, some would say the expected social gradient in health impact did not seem to exist in Hong Kong, but may I remind you that, it is only the case when we focus on COVID-19-specific incidence and mortality alone. But can we really deduce from this that COVID-19-related health inequality does not exist in Hong Kong? According to the Social Determinants of Health Framework mentioned earlier, the obvious answer is “No, of course not.” And here’s why…
In addition to the direct disease burden, the COVID-19 outbreak and its associated containment measures (such as economic lockdown, mandatory social distancing, and change of work arrangements) could have unequal wider socioeconomic impacts on the general population, especially in regions with pervasive existing social inequalities. Given the limited resources and capacity of the socioeconomically disadvantaged to respond to emergency and adverse events, their general health and well-being are likely to be unduly and inordinately affected by the abrupt changes in their daily economic and social conditions, like job loss and insecurity, brought about by the COVID-19 outbreak and the corresponding containment and mitigation measures of which the main purpose was supposedly disease prevention and health protection at the first place. As such, focusing only on COVID-19 incidence or mortality as the outcomes of concern to address health inequalities may leave out important aspects of life that contributes significantly to people’s health. Recently, my research team and I collaborated with Sir Michael Marmot in a Hong Kong study, and found that the poor people in Hong Kong fared worse in every aspects of life than their richer counterparts in terms of economic activity, personal protective equipment, personal hygiene practice, as well as well-being and health after the COVID-19 outbreak. We also found that part of the observed health inequality can be attributed to the pandemic and its related containment measures via people’s concerns over their own and their families’ livelihood and economic activity. In other words, health inequalities were contributed by the pandemic even in a city where incidence is relatively low through other social determinants of health that directly concerned the livelihood and economic activity of the people. So in this study, we confirmed that focusing only on the incident and death cases as the outcomes of concern to address health inequalities is like a story half-told, and would severely truncate and distort the reality.
Truth be told, health inequality does not only appear after the pandemic outbreak of COVID-19, it is a pre-existing condition in countries and regions around the world, including Hong Kong. My research over the years have consistently shown that people in lower socioeconomic position tend to have worse physical and mental health status. Nevertheless, precisely because health inequality is nothing new, there are always voices in our society trying to dismiss the problem, arguing that it is only natural to have wealth inequality in any capitalistic society. However, in reckoning with health inequalities, we need to go beyond just figuring out the disparities or differences in health status between the poor and the rich, and we need to raise an ethically relevant question: are these inequalities, disparities and differences remediable? Can they be fixed? Can we do something about them? If they are remediable, and we can do something about them but we haven’t, then we’d say these inequalities are ultimately unjust and unfair. In other words, a society that prides itself in pursuing justice must, and I say must, strive to address and reduce these unfair health inequalities. Borrowing the words from famed sociologist Judith Butler, “the virus alone does not discriminate,” but “social and economic inequality will make sure that it does.” With COVID-19, we learn that it is not only the individuals who are sick, but our society. And it’s time we do something about it.
Thank you very much!//
Please join me in congratulating the incoming executive committee of AMSAHK and giving them the best wishes for their future endeavor!
Roger Chung, PhD
Assistant Professor, CUHK JC School of Public Health and Primary Care, @CUHK Medicine, The Chinese University of Hong Kong 香港中文大學 - CUHK
Associate Director, CUHK Institute of Health Equity
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Taiwan Social Welfare Organizations support Taiwan’s meaningful participation in the 2018 WHA
As declared in the WHO Constitution, “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” In light of this founding principle, we submit that every Taiwanese citizen has the fundamental right to participate in the WHA and the WHO.
The WHO has long espoused Universal Health Coverage (UHC) and promoted children’s early development as well as adolescents’ health and welfare around the world. In this spirit, Taiwan was the first Asian country to institute UHC, and has achieved an insurance coverage rate of 99.9% through relatively low annual health expenditures of 6.3% of GDP. Taiwan is willing and able to share the lessons it has learned from this successful experience with other nations at the WHA. Without Taiwan’s attendance at the WHA, and participation in the WHO’s technical meetings, co-operations and activities, the global health system would certainly lose a crucial and valuable collaborative partner, and significantly delay the implementation of the WHO’s central objective: improving the health and welfare of all people.
In a statement issued on Rare Disease Day 2018, the WHO emphasized that the concept of UHC embraces access to needed health care for all people, including sufferers of rare disease, without imposing undue financial hardship. Taiwan was the only nation to have officially incorporated rare disease prevention and patient welfare into its Rare Disease Act legislation. Its National Health Insurance system provides full reimbursement for all needed medication, and subsidizes special nutritional supplements and emergency medication for rare disease patients. Taiwan’s outstanding accomplishments and experience in the care of rare diseases should be shared internationally to galvanize the advancement of UHC.
Over the past decades, Taiwan government and social welfare organizations also have dedicated to seeking necessary resource as healthcare, medicines-supply and social caring for disadvantaged groups through legislation, advocacy or group-interaction which to construct a solidity and energetic social welfare system. To ensure every disadvantage people can be taken care of under a proper medical system. No necessary considering potential financial risks among families to secure basic health and security.
Taiwan has been actively participating in international health care organizations for a long time. Taiwan’s non-governmental organizations have spread across the world. There are more than 73 countries, 336 major plans and international exchanges have been implemented and there is countless substantive diplomacy happened. The step-by-step, pragmatic, and true occurrence means that Taiwan has the ability to make substantial contributions to help the disadvantaged groups around the world.
Taiwan social welfare organizations are willing to share the mission and experience in the caring of disadvantaged groups internationally to galvanize the advancement of UHC. Taiwan social welfare organizations have shared our experiences through Pragmatic Diplomacy internationally, so please don’t ignore our efforts. Therefore, we strongly urged Taiwan to be treated fairly. Just as the people with rare diseases cannot be left behind in global health coverage, the health issues of Taiwan’s 23 million people should not become “outside of universal health coverage”. Taiwan should have meaningful participate in the 2018 World Health Assembly, share Taiwan’s experience with the world, help other countries to promote policies that take care of the disadvantaged, face potential health challenges, and jointly realize the health of the World Health Organization as a basic human rights.
臺灣社會福利團體聯合國際記者會 中文聲明
【支持臺灣有意義參與2018年世界衛生大會】
誠如世界衛生組織(WHO)憲章所揭櫫的宗旨:「健康是基本人權,是普世價值,不因種族、宗教、政治信仰、經濟或社會情境而有所分別。」爰此,參與世界衛生大會(WHA)與世界衛生組織(WHO)乃是臺灣每位人民的基本權利。
世界衛生組織長久以來戮力於實踐「全民健康覆蓋(Universal Health Coverage)」的願景,並倡議特殊及弱勢族群的健康與福祉。而臺灣是亞洲地區最早落實全民健康保險制度的國家,納保率達99.9%、醫療花費僅佔GDP約6.3%,有意願也有能力在世界衛生大會向各國分享相關經驗。然而臺灣無法出席世界衛生大會及全面參與世界衛生組織相關技術性會議、機制及活動的結果,將使全球衛生體系失去一個重要的合作夥伴,延宕世界衛生組織提升全球人類健康水準的目標。
根據世界衛生組織在2018年世界罕見疾病日發布聲明中所強調:「全民健康覆蓋」意味著所有人皆能在免於財務困難的情況下獲得其所需的醫療衛生服務,其中即包括能確保社會各角落的民眾都能獲得所需的醫療照護及關懷服務。而臺灣對於特殊及弱勢族群的完善照護向來是國際衛生領域的表率,在2000年成為全球第一將罕見疾病防治與福利保障正式立法之國家,因此在臺灣,這些罹患罕見疾病的孩童,都能在妥善的醫療體系下被照護,所以臺灣儼然是世界衛生組織推動「全民健康覆蓋」目標的重要典範。
數十年來,臺灣政府與民間社福團體不遺餘力結合多方資源,透過立法、倡議或團體互動等方式,保障特殊及弱勢族群必要的醫療照護、藥物供給及社會關懷服務,齊力建構功能健全、服務能量滿載之醫療及社會福利體系,讓每位特殊及弱勢朋友都能在妥善的醫療體系下被照顧、在免於財務風險的家庭中成長,保障其應有的基本健康與安全。
臺灣長久以來積極參與國際健康照護組織,台灣民間團體的足跡遍佈全球,目前已經超過73個國家、重大計畫案次數超過336次其他大小國際交流、實質外交不計其數。一步一腳印的、務實的、真實的發生,亦即代表臺灣有能力、有使命為幫助全世界弱勢族群做出實質貢獻。
臺灣的社會福利團體願意將照護每位特殊及弱勢朋友的使命與經驗分享到全世界,用於協助世界衛生組織推動「全民健康覆蓋」的願景,台灣社福團體用實質外交交流,將經驗貢獻至全球,請世界衛生大會不要忘了我們民間團體的努力,所以我們強力支持並呼籲臺灣應該被公平對待之,正如極少數的罕見疾病患者不容見棄於全球健康覆盖之外,台灣2300萬人的健康議題,更不應該成為「全民健康覆蓋」之外的世界孤兒,讓臺灣有意義參與2018年世界衛生大會,將臺灣的經驗分享給全世界,協助其他國家推動照顧弱勢之政策及面對潛在的衛生挑戰,共同為實現世界衛生組織所揭示健康為基本人權之願景而努力。
Co-signatories:
社團法人台灣社會福利總盟(Taiwan Social Welfare League)
財團法人罕見疾病基金會(Taiwan Foundation for Rare Disorders)
財團法人勵馨社會福利事業基金會(The Garden of Hope Foundation)
財團法人陽光社會福利基金會(Sunshine Social Welfare Foundation)
財團法人伊甸社會福利基金會(Eden Social Welfare Foundation)
社團法人中華民國身心障礙聯盟(Disability Alliance of Republic of China)
社團法人中華民國智障者家長總會(Parents Association for Persons with Intellectual Disabilities)
社團法人臺灣社會工作專業人員協會(Taiwan Association of Social Workers)
社團法人台灣社會心理復健協會(Taiwan Association for Psycho-Social Rehabilitation)
財團法人基督教芥菜種會(The Mustard Seed Mission)
社團法人台灣少年權益與福利促進聯盟(Taiwan Alliance For Advancement of Youth Rights And Welfare)
社團法人台灣南方社會力聯盟(Social Power from Southern Taiwan)
社團法人台灣婦女團體全國聯合會(National Alliance of Taiwan Women's Associations)
社團法人中華民國社區重聽福利協會(Taiwan Association for Community Hard-Of-Hearing People And Welfare)
社團法人中華民國白化症者關懷協會(Taiwan Albino Caring Association)
財團法人靖娟兒童安全文教基金會(Jing Chuan Child Safety Foundation)
社團法人中華民國老人福利推動聯盟(Federation for Welfare of the Elderly)
社團法人中華民國自閉症總會(Autism Society of Taiwan)
社團法人台灣健康人權行動協會(Taiwan Health Right Initiative)
財團法人台灣兒童暨家庭扶助基金會(Taiwan Fund for Children and Families)
社團法人中華民國家庭照顧者關懷總會(Taiwan Association of Family Caregivers)
社團法人台灣多發性硬化症協會(Multiple Sclerosis Association Taiwan)
social welfare中文 在 翁靜晶 Facebook 的最讚貼文
英國友人埃里克.何東先生(His Excellency Ambassador Eric Hotung CBE,中文名為何鴻章)是已故香港最具影響的首富羅伯特.何東爵士的長孫、香港工商界鉅子和華社社團領導。
他一九二六年生於香港,孩提和青少年時代在上海渡過。一九四七年赴美, 一九五一年畢業於美國喬治城大學,曾在紐約股票交易所、通用汽車公司等任職。一九五六年和一九五七年,其祖父和父親相繼去世,他回到香港繼承家業,先從事進出口貿易,後經營房地產開發和金融證券,其產業從香港擴展到歐美,與國際上的金融界和證券交易所建立了廣泛聯繫。
何鴻章先生繼承家族傳統,熱心公眾和慈善事業。為此,於一九六五年創建“何鴻章信託基金會”,以發展香港及其他地區和國家的教育。由於廣泛參與和讚助國際社會活動,何先生被許多國家不同類型的社會團體,特別是文化教育領域的社團聘為理事和董事。其中,從八十年代起歷任美國喬治城大學和菲律賓國際問題研究中心董事、中美關係全國委員會和宋慶齡基金會等組織的理事。一九九九年,東帝汶人民經過多年浴血奮戰取得獨立後,何鴻章先生又慷慨解囊,不但捐巨資,還提供船隻協助載送難民回國,並在東帝汶成立何鴻章信託基金會。為了感謝他,東帝汶任命他為該國經濟和金融特別顧問,許多國家對他的慷慨之舉也給予嘉獎。
作為中國人民的老朋友,何鴻章先生非常關心中國的發展,熱心於中國的公益事業,慷慨贊助中國的文化和教育。自八十年代起至今捐款總額(不包括香港)已達數千萬人民幣。此外,他為促進中美兩國之間的了解和關係的改善也付出了大量的心血,做出了積極貢獻。鄧小平、江澤民、李鵬、朱容基、李瑞環、葉劍英、鄧穎超、楊尚昆等中國領導人都分別會見過他。
His Excellency Ambassador Eric Hotung C.B.E (The Patriot of British Empire), known as He Hongzhang by his Chinese name, is the eldest grandson of Sir. Robert Hotung - last of the Merchant Princes and a leader of the Chinese community.
Born in 1926 in Hong Kong, he spent his childhood and youth in Shanghai. He went to the United States in 1947 and graduated from the Georgetown University in 1951. He had worked in New York Stock Exchange, General Motors and other places. Following the passing away of his grandfather in 1956 and his father in 1957, he returned to Hong Kong to inherit his family's property. At first, he was engaged in import and export trade, and then he went in for real estate development, as well as securities. His business expanded gradually from Hong Kong to Europe and the United States, and in the meantime, he established contacts with financial circles and stock exchanges worldwide.
Carrying on the fine tradition of his family, H.E. Ambassador Hotung has always been enthusiastic in promoting public welfare and the cause of charity. For this, he founded the "Eric Hotung Trust Fund" in 1965 with the aim of developing education in Hong Kong, and other regions and countries. Owing to his wide participation in and warm support to international social activities, he was appointed by many counties as director or council and education. For instance, starting from 1980's he became members of the board of directors of the Georgetown University in the United States and the Research Centre of International Studies in the Philippines. He also serves as Council Member and Trustee of the American National Committee on U.S. - China Relations and the Song Qing Ling Foundation in China. In 1999, after the Timorese people won independence through years of fighting in bloody battles, H.E. Ambassador Hotung, was one of the first individual to come to the country's assistance by donating money, a ship to return refugees and establishing the Hotung Institute for Timor-Leste. He has been appointed by the Timor-Leste government as Ambassador at Large and Economics Advisor for Timor-Leste. Many countries have acknowledged his generosity.
As an old friend of the Chinese people, H.E. Ambassador Hotung is very concerned about China's development, warmheartedly supports her public welfare, and generously donates money to her cultural and educational cause. Since the 1980's his total donation to China(excluding Hong Kong)has reached tens of millions RMB, besides, he has also done much work and contributed positively to the understanding and improvement of relations between China and the United States. Chinese leaders like Deng Xiaoping, Jiang Zemin, Li Peng, Zhu Rongji, Ye Jianying, Deng Yingchao, Yang Shangkun have all met him personally.
來源:http://www.erichotung.com/
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